Does sex affect 30-day mortality in staphylococcus aureus bacteremia?

Background: Sex-related differences in complications and mortality of infection were examined with conflicting results. Further studies are required to bring new light in this topic in Staphylococcus aureus infections. Objective: We examined the outcomes of S. aureus infection in men and in women and whether sex-related differences were explained by underlying disorders, severity of disease, or clinical management. Methods: This cohort study was conducted in a single center between 1988 and 2007. Patients with clinically significant S. aureus bacteremia were included. We compared 30-day all-cause mortality in men and women. We used multivariable logistic regression analysis to test whether sex was independently associated with mortality. Results: One thousand ninety-three patients were identified with S. aureus bacteremia. All-cause mortality at day 30 was 39.3% (508 of 1293 patients): 44.8% (238 of 531 patients) in women and 35.4% (270 of 762 patients) in men (P < 0.01). In a multivariate analysis, female sex was associated with higher mortality (odds ratio = 1.63; 95% CI, 1.07-2.47). The excess mortality in women was not explained by differences in demographic characteristic factors, background conditions, infection severity and management, or septic complications. Conclusions: We found that women with S. aureus bacteremia had a greater risk of 30-day all-cause mortality than men, even when adjusting for other risk factors. However, we failed to explain this excess of mortality.